[The role of calcium sensitive and vitamin D receptors in the pathogenesis of sporadic multiple parathyroid gland disease].

BACKGROUND: Sporadic multiple parathyroid gland disease is » cases of primary hyperparathyroidism (PHPT). However, a single tactic for diagnosing and operating volume in patients with this variant of PHPT has not yet been developed. One of the possible directions in the search for pathogenetically substantiated methods of diagnosis and treatment is the study of the molecular genetic features of the disease and associated clinical and laboratory factors. AIM: To study the features of the expression of calcium sensitive (CaSR) and vitamin D (VDR) receptors on the surface of parathyroid cells in primary hyperparathyroidism with solitary and multiple lesions of the parathyroid glands, as well as its changes under the influence of a decrease in the filtration function of the kidneys. MATERIALS AND METHODS: In a single center observational prospective study with retrospective data collection, there were patients who during 2019-2021. operated on for PHPT, secondary hyperparathyroidism (SHPT) and all cases of tertiary hyperparathyroidism (THPT) operated during 2014-2021. The expression of CaSR, VDR and its relationship with the main laboratory parameters, the clinical variant of hyperparathyroidism, and the morphological substrate were studied. RESULTS: The study included 69 patients: 19 with multiple and 25 with solitary PTG near PHPT, 15 with SHPT, 10 with THPT. A statistically significant decrease in the frequency of detection of normal expression of CaSR and VDR receptors occurs in any morphological variant of hyperparathyroidism and is observed in 93-60% of drugs. A decrease in the normal expression of CaSR in hyperplasia is detected statistically significantly less frequently than in adenoma (p≤0.01). The median expression intensity in adenoma was 2.5 (2:3), in hyperplasia 3.5 (3-4) (p≤0.01). The difference in the molecular mechanisms of the development of hyperparathyroidism with a predominance of a morphological substrate in the form of adenoma (PHPT with solitary adenoma) or hyperplasia (SHPT and PHPT with multiple PTG lesions) is realized in the frequency of maintaining normal CaSR expression in the PTG tissue. These mechanisms are implemented at the local level, their variability does not change under the influence of RRT. A common molecular genetic mechanism for the development of hyperparathyroidism with a predominance of a morphological substrate in the form of adenoma or hyperplasia has been found to reduce the frequency of maintaining normal VDR expression in PTG (up to 7-13%), p<0.01. This mechanism is implemented at the local level, its variability changes under the influence of RRT, reaching statistically significant differences in patients with THPT. CONCLUSION: The study demonstrates the features of changes in the expression of CaSR and VDR in PHPT with multiple lesions of the parathyroid glands. The relationship between the expression of these receptors and the clinical variant of hyperparathyroidism, the morphological substrate, the main laboratory parameters, and renal function was shown.

Helium focused ion beam irradiation with subsequent chemical etching for the fabrication of nanostructures.

In this paper we demonstrate a nanofabrication technique based on local ion irradiation of silicon dioxide with a focused helium ion beam. The wet etching of silicon dioxide irradiated with a focused helium ion beam is described in a two-dimensional case both numerically and experimentally. We suggest a model for the etching process based on the distribution of ion induced defects in the irradiated material. The profile of the surface of the etched silicon dioxide is simulated and compared with the results from scanning electron microscopy. Fabrication of a suspended nanostring with a diameter of less than 20 nm by means of etching ion-irradiated material is demonstrated.

International registry on the use of the CytoSorb® adsorber in ICU patients : Study protocol and preliminary results.

INTRODUCTION: The aim of this clinical registry is to record the use of CytoSorb® adsorber device in critically ill patients under real-life conditions. METHODS: The registry records all relevant information in the course of product use, e. g., diagnosis, comorbidities, course of the condition, treatment, concomitant medication, clinical laboratory parameters, and outcome (ClinicalTrials.gov Identifier: NCT02312024). Primary endpoint is in-hospital mortality as compared to the mortality predicted by the APACHE II and SAPS II score, respectively. RESULTS: As of January 30, 2017, 130 centers from 22 countries were participating. Data available from the start of the registry on May 18, 2015 to November 24, 2016 (122 centers; 22 countries) were analyzed, of whom 20 centers from four countries provided data for a total of 198 patients (mean age 60.3 ± 15.1 years, 135 men [68.2%]). In all, 192 (97.0%) had 1 to 5 Cytosorb® adsorber applications. Sepsis was the most common indication for CytoSorb® treatment (135 patients). Mean APACHE II score in this group was 33.1 ± 8.4 [range 15-52] with a predicted risk of death of 78%, whereas the observed mortality was 65%. There were no significant decreases in the SOFA scores after treatment (17.2 ± 4.8 [3-24]). However interleukin-6 levels were markedly reduced after treatment (median 5000 pg/ml before and 289 pg/ml after treatment, respectively). CONCLUSIONS: This third interim report demonstrates the feasibility of the registry with excellent data quality and completeness from 20 study centers. The results must be interpreted with caution, since the numbers are still small; however the disease severity is remarkably high and suggests that adsorber treatment might be used as an ultimate treatment in life-threatening situations. There were no device-associated side effects.

[Pharmacological neuroprotection for intracerebral hemorrhages in patients with polyvascular disease]. / Farmakologicheskaia neiroprotektsiia pri vnutrimozgovykh krovoizliianiiakh u patsientov s mul'tifokal'nym aterosklerozom.

AIM: To evaluate the efficacy of pharmacological neuroprotection with protein, peptide and metabolic drugs as a part of basic intensive therapy for intracerebral hemorrhages in patients with polyvascular disease (PolyVD). MATERIAL AND METHODS: Twenty-eight male patients with PolyVD referred to surgical treatment of intracerebral hemorrhages, who were on mechanical ventilation and received basic intensive care, were included in a single center prospective observational study. All patients were assigned either to routine daily i/v infusions of 10 ml cytoflavin in 0.9% sodium chloride solution for 10 days (n=12) or 0,2 mg daily of cellex subcutaneously (n=16). Central hemodynamics, intracranial pressure, and continuous indicators of the linear velocity of blood circulation were assessed. All patients underwent SOFA scoring. The markers of brain damage, including protein S-100-ß (ng/l), antioxidant enzyme activity of superoxide dismutase (SOD) U/gr/Hb), glutathione peroxidase (U/gr/Hb) in the systemic circulation and jugular vein on the lesion side were determined. The length of stay in the intensive care unit and the number of nights were calculated. Mortality was assessed in both groups. RESULTS: Intracranial hypertension in both groups tended to subnormal parameters by 3-5 days. Vasospasm was reduced more rapidly (by the 3rd day) in the cytoflavin group compared to the cellex group (174 [152; 189] vs. 205 [182; 219], respectively). The latter demonstrated the less extent of cerebral damage according to S100 protein concentration. A comparative analysis showed that the antioxidant activity was significantly higher in the cytoflavin group. The cellex group demonstrated a pronounced trend towards the regression of neurological deficit on the NIHSS (p=0,025). The number of fatal outcomes and nights spent in the ICU were similar in both groups. The in-hospital stay was insignificantly shorter in the cellex group. CONCLUSION: It is recommended to add both antioxidant and neuropeptide pharmacological neuroprotectors in the routine intensive therapy for treating intracerebral hematomas in patients with PolyVD after surgical management.

Access to pure and highly volatile hydrochalcogenide ionic liquids.

The reaction of methylcarbonate ionic liquids with H2S or H2Se offers a highly selective synthesis of analytically pure, well-defined and soluble hydrosulphide and hydroselenide organic salts of general interest. Among them, imidazolium hydrochalcogenides show an astonishingly high volatility for cation-aprotic ILs, which allows their quantitative sublimation below 100 °C/10(-2) mbar and actually results in ionic single crystal growth from the gas phase. Vaporisation and decomposition characteristics were investigated by isothermal TGA measurements and DFT calculations.

Immobilized proteinases in the treatment of diffuse purulent peritonitis.

In vitro experiments on fibrin films using purulent exudate from the abdominal cavity of rats with experimental peritonitis demonstrate the fibrinolytic effect of bacterial proteinases immobilized on a polymeric matrix. The application of Imozimaza in the complex treatment of experimental peritonitis by the way of intraperitoneal lavage resulted in reliable lowering of mortality, due to the lysis of fibrinopurulent abdominal contents and better contact between antibacterial agents and peritonitis pathogens. In the clinic, prolonged abdominal proteolysis was applied to 44 patients with postoperative diffuse purulent peritonitis of >24 h duration. Under the conditions of programmable relaparotomy, intraperitoneal Imozimaza infusion led (as in in vitro tests) to the lysis of fibrinopurulent masses, which contained micro-organisms of an order higher than exudate. It was accompanied by increase in the drainage efficacy, absence of fragmentation of abdominal contents and absence of secondary abscesses. The use of Imozimaza on the background of complex antibacterial treatment and combined homeostatic therapy resulted in lowering of mortality from 65.8% to 27.3%. Complications and contra-indications for Imozimaza use in diffuse purulent peritonitis were not registered.